Provider Demographics
NPI:1184926552
Name:EMBASSY AUTUMNWOOD MANAGEMENT, LLC
Entity type:Organization
Organization Name:EMBASSY AUTUMNWOOD MANAGEMENT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:HANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-927-2060
Mailing Address - Street 1:275 E SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:RITTMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44270-1165
Mailing Address - Country:US
Mailing Address - Phone:330-927-2060
Mailing Address - Fax:
Practice Address - Street 1:275 E SUNSET DR
Practice Address - Street 2:
Practice Address - City:RITTMAN
Practice Address - State:OH
Practice Address - Zip Code:44270-1165
Practice Address - Country:US
Practice Address - Phone:330-927-2060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMBASSY AUTUMNWOOD MANAGEMENT, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory